Atopic dermatitis is a chronic pruritic inflammatory skin disease. It significantly worsens the quality of life of children and adults because the lesions are often in places visible to those around them, such as the face and hands, but also because of the constant itching that often makes it difficult for them to sleep. In addition, the need for constant use of emollients and specially formulated cleansers and moisturisers increases the cost of treatment.
Causes of the disease
The cause of the disease is not fully understood. Sufferers are affected from birth by disorders of filangrin, a structural protein of the epidermis, and reduced ceramides, a class of skin lipids. These disturbances in the structure of the epidermis lead to greater water loss. In addition, the disturbances in the skin's immune mechanisms allow for greater staphylococcal proliferation and more frequent bacterial and viral infections. The most important disorder in atopic dermatitis is the process of inflammation, generated by T lymphocytes.
Epidemiology
Atopic dermatitis affects 10-20% of children and 1-3% of adults with variations by geographical region. 45% of cases are diagnosed in the first 6 months of life. In 70% of children atopic dermatitis will pass before puberty. Children with atopic dermatitis before the age of 2 years have a 50% chance of developing asthma or allergic rhinitis in the following years. Severe atopic dermatitis in childhood is associated with an increased risk of food allergen allergy.
Clinical events
The appearance of the lesions starts from the limbs, neck, head and cheeks and over time extends to the trunk. The lesions are red, with swelling, blisters and intense itching. Over time the skin becomes thicker.
Prevention
It is recommended to wear loose cotton clothes and avoid woolen ones. Swimming in chlorinated pools, use of a special diet and avoidance of dust, mites and pet dander may have a place as appropriate.
Hydration is a key factor in reducing relapses. Bathing with lukewarm water for 15-20 minutes is recommended. The use of oat products for cleansing can have a soothing effect. Emollients, applied immediately after the bath, to prevent evaporation of water and contribute to restoring the integrity of the skin. Many modern emollients contain biomimetic agents of hydrocortisone to reduce inflammation. Products with urea up to 15% or ammonium lactate 12% are effective in treating dry skin and restoring skin lipids.
Classical therapeutic medicinal agents
The use of antihistamines reduces itching in some cases.
Topical steroids should be used until control of the disease is achieved. Long-term continuous use has been associated with well-documented adverse effects such as skin atrophy.
Topical calcineurin inhibitors are indicated for intermittent use for periods of up to 1 year.
In extensive disease, treatment 1fromThe oral corticosteroids are the drugs of choice. Cyclosporine has proven to be a very good treatment 2from line in cases where steroids cannot be given. Phototherapy with UVB radiation also has good results.
In cases of bacterial contamination, antimicrobial treatment is added.
Biological factors in atopic dermatitis
The newest therapeutic agents in atopic dermatitis are biological agents and small molecules. In Greece, biological agents and small molecules in pill and injectable form are expected to be launched. Results from their use in Europe and the USA show very good efficacy and safety.
Studies in the coming years are expected to add additional reliable treatments to the treatment of atopic dermatitis.
A dermatologist is the specialist doctor who will diagnose the problem you are facing and apply the appropriate treatment to relieve us of any risk.
Source : www.edae.gr
